CONCEPT NOTE

During the 2006 High Level Meeting on AIDS, countries committed themselves to scale up towards Universal Access (UA) to HIV prevention, treatment, care and support. The UA Assessment Report submitted at this meeting identified the availability of affordable commodities, including quality medicines and diagnostics, as a key factor for moving towards Universal Access.

Indeed, at the end of 2006, WHO data showed that a total of 2 million people were accessing antiretroviral treatment, an increase of about 700,000 people from the 1.3 million people accessing antiretroviral treatment by the end of 2005. Of those, an increasing number of people on HIV treatment will need to switch from first-line antiretroviral treatment to second- and third-line combinations. Further, the mutually reinforcing and deadly association of Tuberculosis and HIV is also expected to increase the demand for new drugs, especially to treat resistant Tuberculosis. However, the prices of newer drugs and diagnostics are still high in many parts of the world.

Prevention efforts are equally affected by affordability issues, jeopardizing efforts to scale up implementation strategies to prevent mother to child transmission, ensure blood safety, and ensure wide access to preventive measures such as condoms and harm reduction measures.

Countries are trying to deal with these challenges, with varying degrees of success. Between 1997 and 2004, Brazil succeeded in a reduction of the average cost of antiretroviral drugs to almost one fifth of the original cost, through the use of multiple strategies, such as the local production of generic drugs and price negotiations with pharmaceutical companies. There are also several examples of global collaboration towards improving the availability of affordable commodities, such as the Clinton Foundation, which has been highly successful in antiretroviral drugs price negotiation, including a recent price reduction for 16 medicines in 66 countries, including second-line drugs.

However, as countries move to scale up their national AIDS responses, many continue to face difficulties and have expressed frustration in negotiating better access to commodities. Much remains to be done, especially with regard to issues of intellectual property rights, product development processes, demand forecasting, procurement systems, and legislation.

The 2008 UN High Level Meeting is an important and strategic opportunity to review progress towards Universal Access. It is important to note that the commitment to scaling up towards Universal Access in 2010 was intended as a mid-point towards achieving the Millennium Development Goals (MDGs). Beyond the obvious MDG 6 (to halt and reverse the spread of the AIDS epidemic), many obstacles in the path to Universal Access are systemic and will impinge upon the achievement of several other MDGs. For instance MDG 8 (to develop a global partnership for development) includes a specific target on access to affordable drugs. Such obstacles will also impact broader development to strengthen national health systems. Indeed, the availability of affordable commodities is critical to the achievement of major development efforts of our time.

This satellite event aims to maximize the opportunities for review of progress towards Universal Access, and to explore potential actions to improve availability of affordable commodities for the achievement of MDG 6 and other MDGs.